Is it a conflict of interest for me to be on an injury board at a company where I am an occupational health RN?

I work as an occupational health RN at an clinic onsite. My company has developed an injury classification board. They want me to participate, review work-related injuries, vote and be involved in determining work relatedness and documentation. Is this a conflict of interest, because these employees are seen in the occupational health clinic by me and I assist them with the insurance claims?

Adam

Nancy Brent replies:

Dear Adam,

Your question is interesting and so is the establishment of an injury classification board at your clinic. Your status as the occupational health nurse is a little unclear, however. Are you employed by the clinic or do you work for your company that provides occupational health nursing services — and maybe the insurance carrier or some other cost-containment entity?

The answer to the above question might result in a different response. However, suffice it to say that as the OHN, you do have certain ethical obligations to the workers to whom you provide services. One major obligation is to ensure that the worker's privacy and confidentiality of health information is protected, not only under the OHN Code of Ethics, but also under the Health Insurance Portability and Accountability Act and other applicable state and federal laws. Because you are involved in deciding whether the worker can return to work, your presence on the board while protecting the worker's privacy and confidentiality of health information, might be a real addition to the decision-making process.

Also, it may be that your role on the board is a little bit of "case management" of the worker's illness or injury and eventual return to work, if possible. This is a role many OHNs have undertaken with good results.

You might want to seek an opinion from the American Association of Occupational Health Nurses (www.aaohn.org), in order to review its position on this issue. The website has additional resources that might help if you decide to undertake membership on this board. Those resources include the OHN Code of Ethics and position statements, “The Occupational Health Nurse As Case Manager” and “Confidentiality of Employee Health.”

If you decide to become a member of the board, your role should be spelled out carefully with the other members. Indeed, a written agreement of what your role will be and what services and information can and cannot be included might be a good idea.

Also, it would be a good idea to inform each worker of your role on the board and get their permission to share only pertinent and applicable information about their work relatedness. If they do not give their permission, then you would not be able to participate in their status determinations.

Cordially,Nancy

Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.